With eyes closed, the patient should be instructed to acknowledge hearing the gentle rubbing of the examiner's fingers approximately 3-4 inches away from his right and left ear.
A watch, which the examiner can hear at a specific distance from his ear, is placed next to the patient's ear. Ask him to note when the watch sound disappears. Note that the examiner has to have normal hearing to do this exam (in at least one ear).
In a quiet room, the patient should be able to hear the physician's fingers rubbed lightly together 3-4 inches from his ear.
Progressive bilateral presbycusis (old hearing): Sensory neural loss